Pro-abortion activists have been making the point that, when the U.S. Supreme Court invalidated its own 50year-old precedent that the U.S. Constitution protects the procedure, it in fact rejected women’s right to a form of health care. Opponents have insisted that the court was, in fact, defending the right to life, even for the unborn.

However, the statistics indicate that adequate reproductive care is often crucial to women’s health, especially for African Americans. The record shows that lack of such care can result in unnecessary maternal and infant death.

In fact, according to one expert, gynecology itself was developed using enslaved African women as test subjects. “The history of this particular medical branch … it begins on a slave farm in Alabama,” historian and author Deirdre Cooper told the Associated Press (AP).

“The advancement of obstetrics and gynecology had such an intimate relationship with slavery and was literally built on the wounds of Black women,” said Cooper, a University of Connecticut associate professor and author of the 2017 book “Medical Bondage: Race, Gender, and the Origins of American Gynecology.”

According to the AP, reproductive surgeries such as cesarean sections, which were experimental at the time, were commonly performed on enslaved Black women. J. Marion Sims, an Alabama doctor whom some regard as the “father of gynecology,” performed “torturous surgical experiments on enslaved Black women in the 1840s without anesthesia. And well after the abolition of slavery, hospitals performed unnecessary hysterectomies on Black women and eugenics programs sterilized them.”

Today, African American women have to cope not only with the invalidation of a federal right to abortions but also the enactment by a handful of states of laws that make them illegal after six weeks of pregnancy. Also, for 14 years now, some states are still refusing to accept federal assistance to expand health insurance coverage for low-income people. Florida and Texas are prime examples of this.

More than 6.7 million females aged 15 to 49 live in 26 states where abortions are severely restricted or banned. Many are considering not having children or relocating, the Guardian reported, citing polling by the National Partnership for Women & Families and Our Own Voice. Some 2.7 million are “economically insecure” and unlikely to be able to afford to travel for abortion care, the study found.

Even prior to the Supreme Court’s June 2022 elimination of the right to an abortion, research had shown that “mothers unable to access abortion care experienced increased financial challenges for themselves and their children,” the Guardian said. Some 70 percent of those who are uninsured and 49.8 percent who have Medicaid coverage live in the states which limt access to abortion.

And there is a connection between abortion restrictions and maternal death rates, which are 62 percent higher in 17 states than the national average, the Guardian said, citing a Commonwealth Fund study. The Gender Equity Policy Institute reported that women in those states are nearly three times as likely to die during pregnancy, childbirth or soon after giving birth.

Texas, for example, prohibits abortions after six weeks of pregnancy, with no exceptions for rape, incest or lethal fetal abnormality, with the possibility of life-imprisonment for violating the law. Its maternal mortality rate is historically about the same as the national average, at 20.2 deaths per 100,000 live births. However, a National Bureau of Economic Research study showed that “the effects of structural racism on Black mothers overpower socio-economic factors like household income, so the wealthiest Black women and their newborns will still experience worse outcomes than those from the lowest-income white families,” the Guardian reported.

Texas, which is one of the states that refuse to accept federal incentives to expand Medicaid under the Affordable Care Act (ACA), also known as Obamacare after President Barack Obama, has “the highest number of uninsured residents in the U.S. as well as the highest percentage of uninsured women of childbearing age.” Expanding Medicaid under the ACT, the Guardian pointed out, would benefit African American women, in particular, because nearly two-thirds are on Medicaid when they give birth, compared to one-third of European American women. Without Medicaid coverage, they would, of course, have no health insurance.

“In perhaps one of the most striking findings, and in line with previous years’ data, the latest Texas report showed 90 percent of maternal deaths in the state in 2019 were probably preventable,” the Guardian said.

Still, even as the abortion debate rages, efforts to scuttle the ACA continue 14 years after it was launched. Republicans are still trying to defund it, even after losing hundreds of court cases and failed attempts in Congress. Besides Texas and Florida, eight other states continue to reject the federal subsidies that would make health insurance affordable for more than two million low-income people: Alabama, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Wisconsin and Wyoming.

If those states accept federal assistance, research has shown, the uninsured rate would decline by 25 percent overall, the Robert Wood Johnson Foundation has said. For African American women of reproductive age, it would be a 51.3 percent reduction; for African American adults, generally, it would be 43.2 percent.

But while abortion restrictions and lack of health insurance disproportionately affect African American women, they are only the latest examples of a wider problem which all African Americans face.

In Florida, which has a six-week abortion ban and refuses to expand Medicaid under the ACA, the Palm Beach Post marked Black History Month last year by reporting that African Americans in the state are “sicker, poorer, less educated” when compared with European Americans.

The Post cited a Florida Department of Health report which said that, between 2018 and 2020, the death rate from heart disease for African Americans 35 and older was 338 per 100,000 or 18.6 percent higher than for European Americans, at 285 per 100,000 – even though African Americans are only 15 percent of the population and European Americans are 56 percent. The stroke death rate was 120 per 100,000, compared to 76, and the infant mortality rate was 11.26, compared to 4.29.

This disparity exists nationally and is due to “medical racism,” which the AP cited in a report last year, along with “bias and inattentive care that Black Americans endure.” The news agency said it came to that conclusion after conducting a year-long study that examined “the health disparities experienced by Black Americans across a lifetime.” Those disparities create “health challenges” that “often begin before their first breath.”

The AP concluded: “To be Black anywhere in America is to experience higher chronic ailments like asthma, diabetes, high blood pressure, Alzheimer’s and, most recently, COVID-19. Black Americans have less access to adequate medical care; their life expectancy is shorter. From birth to death, regardless of wealth or social standing, they are far more likely to get sick and die from common ailments.”

The AP said it based its findings on interviews with doctors, other medical professionals, advocates, historians and researchers. They “detailed how a history of racism that began during the foundational years of America led to the disparities seen today.”

Those findings, the AP said, contradict the long-held belief that the health problems of African Americans are due to genetics or behavior. The reality is that “an array of circumstances linked to racism – among them, restrictions on where people could live and historical lack of access to care – play major roles. … Discrimination and bias in hospital settings have been disastrous.”

A higher mortality rate among African Americans, the AP said, led, over the past two decades, to “1.6 million excess deaths compared to white Americans. That higher mortality rate resulted in a cumulative loss of more than 80 million years of life due to people dying young and billions of dollars in health care and lost opportunity.”